Frequency of Spondyloarthropathy in Patients with Celiac Disease

Background/Aims: Celiac disease (CD) is a chronic autoimmune systemic disease characterized by extraintestinal involvement. The existing pathogenic mechanisms of CD may lead to the development of spondyloarthropathies. The aim was to determine the frequency of spondyloarthropathy in CD.

Materials and Methods: Celiac patients followed up in the gastroenterology clinic were evaluated clinically and radiologically by rheumatologists. Patients with spondyloarthropathy were recorded.

Results: A total of 82 patients (20 male, 62 female) were included. The mean duration of CD was 4.85 (SD ± 6.28) years. Inflammatory low back pain was found in 43.9% of patients. Of the 36 patients who underwent sacroiliac magnetic resonance imaging (MRI), 12 (33.3%) had sacroiliitis. Among these, 4 patients (33.3% of those with sacroiliitis, 4.9% of the total cohort) had active sacroiliitis, and 8 (66.7% of those with sacroiliitis, 9.8% of the total cohort) had chronic sacroiliitis. Human Leukocyte Antigen B27 (HLA-B27) positivity was not significantly associated with MRI findings or clinical activity in the cohort. Two patients had knee monoarthritis.

Conclusion: The frequency of spondyloarthropathy may be associated with factors such as persistent antigenic stimulation of the intestinal mucosa, disruption of the mucosal barrier, T lymphocyte activation, and intestinal dysbiosis in CD. A notable frequency was observed in inflammatory low back pain and sacroiliitis in patients with CD was found.

Cite this article as: Koç E, Albayrak F, Taşdemir Ü, et al. Frequency of spondyloarthropathy in patients with celiac disease. ArchRheumatol. Published online April 10, 2026. doi:10.5152/ArchRheumatol.2025.25041